CERTIFICATE OF LIABILITY INSURANCE (2)
~ ACOROTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
08-25-05
PRODUCER! THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33622-2668
813289-5200 INSURERS AFFORDING COVERAGE
INSURED INSURER A: United States Fidelity & Guaranty .
Grimail Crawford, Inc. INSURER B: St Paul Fire & Marine
5444 Bay Center Dr. INSURER C: Hudson Ins Co
Suite 204 INSURER 0:
I Tampa, FL 33609 INSURER E:
Client#.6108
GRIMCRA3
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER Pgi!frl(~~gTm P~'A'~.r rr::}~N LIMITS
LTR
A GENERAL LIABILITY BK01231322 10/14/04 10/14/05 EACH OCCURRENCE $1 000000
f--
lL COM M ERCIAL GENERAL L1AB ILITY FIRE DAMAGE (Anyone fire) $300 000
~ CLAIMS MADE W OCCUR MED EXP (Anyone person) $10000
-
PERSONAL & ADV INJURY $1 000,000
-
GENERAL AGGREGATE $2 000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2,000.000
I POLICY !Xl j:C?;:. n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ee eccident) $
- ANY AUTO.
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per eccident)
-
PROPERTY DAMAGE $
(Per eccident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
o OCCUR D CLAIMS MADE AGGREGATE $
. R::::::~E._~~ $
$
- ------. -----~-- .- - ---.---- - --- --- - - -."- -"-" -- -- - - --- - ---- - $-
B WORKERS COMPENSATION AND WVA7753374 OS/22/05 OS/22/06 X ,-WC STATU- 1 IOJ~-
EMPLOYERS' LIABILITY $1,000,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPL OYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1 000,000
C OTHER AEE7137100 OS/29/05 OS/29/06 $1,000,00 per claim
Professional $1,000,000 aggregate
iability
DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Professional Liability is claims made and reported.
RE: Engineer of Record. Mike Crawford
CERTIFICATE HOLDER I I ADDITIONAL INSURED . INSURER LETTER: CANCELLATION
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30....-DAYSWRITTEN
Susan Chase, Document & Records Supervisor NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHELEFT, BUTFAlLURE TODOSOSHALL
PO Box 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
Clearwater, FL 33758-4748 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
I J:J..1 '^ ~J'I ~ a -.
ACORD 25-8 (7/97)1 of 2
#S112469/M110018
KJS
@ ACORD CORPORATION 1988